This document discusses prescription drug costs and spending in the United States healthcare system. It notes that while new breakthrough medicines are improving patient outcomes, prescription drug spending accounts for only a small portion of total healthcare spending that has remained stable in recent years. However, the document also outlines challenges patients face with rising out-of-pocket costs due to non-transparent business practices of middlemen like PBMs and hospitals that inflate list prices. It advocates for policy reforms to lower patient costs and ensure access to needed medicines.
Prescription Medicines Costs in Context - June 2019PhRMA
We are in a new era of medicine where breakthrough science is transforming care with innovative treatment approaches and enabling us to more effectively treat chronic disease, the biggest cost driver.
Prescription Medicines - Costs in Context January 2019PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Prescription Medicines - Costs In Context March 2019PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Prescription Medicines - Costs in Context - August 2018PhRMA
Discussions about the cost and affordability of medicines – and health care more broadly – are important. At the same time, it is important to look at costs across the health care system and not just the share going toward life changing medicines.
Prescription Medicines - Costs in Context - September 2018PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Prescription Medicines - Costs in Context - September 2018PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Prescription Medicines - Costs in Context - October 2018PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Addressing Rising Health Care Costs | CVS HealthCVS Health
CVS Health is committed to lowering health care costs while delivering high-quality care to communities across the country. Learn more: https://cvshealth.com/thought-leadership/addressing-rising-health-care-costs
Medicines Use and Spending Shifts: A Review of the Use of MedicinesIMS Health US
Growth in spending on medicines was higher in 2014 than any year since 2001, and
exceeded forecast overall healthcare spending growth for the first time since 2011.
As 2014 was also a landmark year in the implementation of the Affordable Care Act,
understanding the specific drivers of medicine spending growth is important for decisionmakers
across the healthcare system.
In this report we bring together several perspectives on 2014: total system spending on
medicines at an aggregate and segmented level; the evolution of healthcare demand, delivery
and payment systems; patient out-of-pocket costs for medical and pharmacy benefits including
retail prescription co-pays; and transformations in disease treatment resulting from newly
approved medicines.
Prescription Medicines Costs in Context - June 2019PhRMA
We are in a new era of medicine where breakthrough science is transforming care with innovative treatment approaches and enabling us to more effectively treat chronic disease, the biggest cost driver.
Prescription Medicines - Costs in Context January 2019PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Prescription Medicines - Costs In Context March 2019PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Prescription Medicines - Costs in Context - August 2018PhRMA
Discussions about the cost and affordability of medicines – and health care more broadly – are important. At the same time, it is important to look at costs across the health care system and not just the share going toward life changing medicines.
Prescription Medicines - Costs in Context - September 2018PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Prescription Medicines - Costs in Context - September 2018PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Prescription Medicines - Costs in Context - October 2018PhRMA
Discussions about costs are important. We recognize that many are struggling to access the medicine they need, and have important questions about their medicine costs. And we want to help find the answers.
Addressing Rising Health Care Costs | CVS HealthCVS Health
CVS Health is committed to lowering health care costs while delivering high-quality care to communities across the country. Learn more: https://cvshealth.com/thought-leadership/addressing-rising-health-care-costs
Medicines Use and Spending Shifts: A Review of the Use of MedicinesIMS Health US
Growth in spending on medicines was higher in 2014 than any year since 2001, and
exceeded forecast overall healthcare spending growth for the first time since 2011.
As 2014 was also a landmark year in the implementation of the Affordable Care Act,
understanding the specific drivers of medicine spending growth is important for decisionmakers
across the healthcare system.
In this report we bring together several perspectives on 2014: total system spending on
medicines at an aggregate and segmented level; the evolution of healthcare demand, delivery
and payment systems; patient out-of-pocket costs for medical and pharmacy benefits including
retail prescription co-pays; and transformations in disease treatment resulting from newly
approved medicines.
Prescription Medicines - Insulin Costs in ContextPhRMA
A century ago, patients were treated with animal insulins. Today, biopharmaceutical companies produce insulins that operate at the molecular level, more closely resembling insulin released naturally in the body and more effectively managing the disease. The options available today also help meet a wide range of unmet needs, providing patients with the tools necessary to stay adherent and healthy – saving costs throughout the health care system. However, this innovation isn’t enough if patients can’t afford their insulin and other medicines at the pharmacy.
Prescription Medicines: International Costs in ContextPhRMA
Our new Prescription Medicines: International Costs in Context explains how medicines benefit patients, health care systems, and the global economy. Advances in treatment are tacking some of the world’s greatest public health challenges. These treatments provide critical savings for health care systems by reducing the need for more costly services. What’s more is the profound impact that biopharmaceutical companies have on the global economy, including the creation of high-skill jobs, R&D investment, and medicines that improve worker productivity.
2016 Report: Medicines in Development for Alzheimer's DiseasePhRMA
Today, more than 5 million Americans have Alzheimer’s disease. The disease devastates the minds of patients, creates substantial burdens for families and caregivers, and currently costs the health care system more than $200 billion a year. These sobering statistics are projected to get much worse as the 76 million American baby boomers age.
This report shows that America's Biopharmaceutical Research Companies Are Developing More Than 70 Medicines for Alzheimer’s Disease
2015 Report: Medicines in Development for Heart Disease & StrokePhRMA
According to the American Heart Association, someone in the United States dies from cardiovascular disease every 40 seconds, and more than 85 million Americans have at least one form of the disease. Heart disease has been the leading cause of death in the United States since 1921, but these numbers are declining. Read this report by PhRMA - in partnership with the Association of Black Cardiologists - on the nearly 200 medicines in development for heart disease & stroke.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. 2
We are in a New Era of Medicine Where Breakthrough Science
is Transforming Patient Care
60 new medicines were approved by the FDA in 2021.
Cancer mortality rates continue
to decline amid 'major progress'
in lung cancer early detection
and treatment
Newly approved drug being
called ‘game changer’ for people
who suffer from hemophilia
FDA authorizes new Covid
antibody drug to fight
omicron variant
Cancer Treatments Game Changer Coronavirus Treatments
Source: US FDA. Center for Drug Evaluation and Research (CDER) Advancing Health through Innovation. 2021 New Drug Approvals.
Note: Due to lack of data availability, novel approvals are not inclusive of medicines approved by the Center for Biologics Evaluation and Research (CBER) in 2020.
Prescription Medicines: Costs in Context www.phrma.org/cost
3. 3
Spending on Medicines Is a Small and Stable Share of Total
Health Care Spending
Prescription medicines
account for just
In 2021, per capita spending
on medicines* declined by
1%
* Excludes spending on COVID-19 vaccines and treatments
Source: Altarum, IQVIA, 2022.
0%
20%
40%
60%
80%
100%
2021 2022 2023 2024 2025 2026 2027 2028
Hundreds
Retail Nonretail* Other health care spending
Projected US Health Care Expenditures Attributable to
Retail and Nonretail Prescription Medicines, 2021-2028
Note: Nonretail prescription medicines are those purchased through physicians’ offices, clinics and hospitals and are typically administered to the patient by the provider. Retail prescription
medicines are those filled at retail pharmacies or through mail service.
Prescription Medicines: Costs in Context www.phrma.org/cost
of total health care spending
14%
4. 4
$0
$1,000
$2,000
$3,000
$4,000
$5,000
Prescription Medicines Other Health Care Cell & Gene Therapy
2021
SOURCES: Young CM et al. Drug Discovery Today, 27(1): 2022.; CMS National Health Expenditures (NHE) Projections, 2022.; Altarum Institute. “Projections of the Non-Retail Prescription Drug Share of National Health Expenditures.” September 2020.
Prescription Medicines: Costs in Context www.phrma.org/cost
2022 2023 2024 2025
Projected Spending on Prescription Medicines, Total Health Care,
and Anticipated Cell & Gene Therapies ($B), 2021-2025
A New Era of Medicine is Not Expected to Impact the Share
of Total Health Care Spending on Medicines
5. 5
Net Prices for Brand Medicines Have Stayed Nearly Flat For
The Past Five Years
2.1%
0.3% 1.7%
-2.9%
1.0%
2017 2018 2019 2020 2021
Average Net Price Growth for Brand Medicines, 2017-2021
On average, a brand
medicine’s net price is
49%
lower than its list price.
Source: IQVIA, 2022.
Prescription Medicines: Costs in Context www.phrma.org/cost
6. 6
Unlike Other Aspects of the Health Care System, Medicine
Costs Decrease Over Time
The price of medicines used to prevent
cardiovascular disease decreased…
…while the cost of the surgical procedure
to treat it increased over a decade.
Source: IQVIA analysis for PhRMA, June 2020.; AHRQ HCUP, July 2020.
Prescription Medicines: Costs in Context www.phrma.org/cost
$2.37
$0.13
-95%
2017
2007
$51,460
$99,859
+94%
2017
2007
7. 7
CONFIDENTIAL
Generic and biosimilar medicines drive significant savings in
the health care system.
Nearly
$2.4 trillion
10-year savings from use of
generic and biosimilars
(2011 - 2020)
91% of All Drugs Dispensed in
the United States are Generics
Looking Ahead, Biosimilar
Savings Projected to Grow 5x
19%
33%
52%
91%
1984 1990 2002 2020
Sources: Drug Channels, AAM, IQVIA.
2014 - 2020
2021 - 2025
$19B
$104B
5.4x
8. 8
The Influence Pharmacy Benefit Managers (PBMs) Have
Over Patient Access and Affordability Continues to Grow
Negotiating power is increasingly concentrated among a small number of PBMs.
Source: Drug Channels Institute, March 2022.
21%
33%
26%
20%
Top 3 PBMs’
Market Share:
80%
OptumRx (UnitedHealthGroup)
CVS Caremark
Express Scripts
All Other
Insurers & PBMs determine:
IF MEDICINE IS COVERED
on the formulary
PATIENT OUT-OF-POCKET COST
based on tier placement
ACCESS BARRIERS
like prior authorization or fail first
PROVIDER INCENTIVES
through preferred treatment guidelines and
pathways
Prescription Medicines: Costs in Context www.phrma.org/cost
9. 9
The Majority of Brand Medicines Face Generic and
Brand Competition
More than 99% of Part D spending in 2019 was for medicines with competition
Class analysis is based on USP classification system. Part D plans are generally required to cover two medicines per USP class, and CMS uses USP to review Part D plan formularies to ensure plans meet formulary standards.
Source: Avalere, 2022.
Prescription Medicines: Costs in Context www.phrma.org/cost
29%
63%
8%
<0.001%
Generics, and brands that have generic versions
Brands without their own generic but in classes
that include generics
Brands in classes with competing brands (but no generics)
Brand medicines alone in their class
10. 10
More than Half of Every Dollar Spent on Brand Medicines
Goes to Entities Who Did Not Develop Them
Prescription Medicines: Costs in Context www.phrma.org/cost
Other Entity Received
Brand Manufacturer
Source: Berkley Research Group, 2022.
11. 11
Insurers, PBMs And Others Receive An Increasing Share Of
Total Spending On Brand Medicines
Total Brand Medicine Spending ($B)
2013-2020
Total Brand Medicine Spending
Received by Payers ($B)
Payers include health plans, PBMs, federal and state governments, and employers
$50.3
$141.1
2013 2020
180% increase
Prescription Medicines: Costs in Context www.phrma.org/cost
Source: Berkley Research Group, 2022.
12. 12
Middlemen are Shifting Costs to Patients Through
Coinsurance and Deductibles
Prescription Medicines: Costs in Context www.phrma.org/cost
Half of commercially insured
patients’ out-of-pocket
spending for brand medicines
is based on the full list price 51.4%
14.3%
34.3%
49%
Copay
Deductible
Coinsurance
Source: IQVIA, August 2020. Fein A, March 2022..
In 2021, rebates, discounts and other payments made by brand manufacturers reached
$236B, but insurers and PBMs do not always share these savings directly with patients.
13. 13
Patients Face Higher Out-of-Pocket Costs at the Pharmacy
Counter than Other Parts of the Health Care System
Source: Drug Channels Institute analysis of National Health Expenditure Accounts, Office of the Actuary in the Centers for Medicare & Medicaid Services, December 2021. Outpatient prescription drug figures exclude
inpatient prescription drug spending within hospitals and nearly all provider-administered outpatient drugs. Figures in billions.
Prescription Medicines: Costs in Context www.phrma.org/cost
Total U.S. Spending
Hospital Care Retail Prescription Drugs
$1,270B
$348B
Total Patient Out-of-Pocket Spending
Hospital Care Retail Prescription Drugs
$47B
$33B
Total hospital spending is much higher
than total prescription drug spending
Yet, total patient spending on medicines
is more than on hospital care
14. 14
Hospitals Account for 1/3 of All U.S. Health Care Spending and
Contribute to Patient Costs by Marking Up Medicines
Hospitals that mark up the cost of medicines can make more from administering
a medicine than the pharmaceutical company that manufactured it.
250%
The average amount
hospitals mark up the cost
of medicines for patients
with commercial insurance
The amount 340B hospitals
receive for administering
medicines to commercially
insured patients is
than what they paid to
acquire the medicines
3x more
634%
Amount some hospitals
mark up the cost of
oncology medicines
Prescription Medicines: Costs in Context www.phrma.org/cost
Source: STAT, 2021. Source: Milliman, 2019.
15. 15
Brand Medicine Spending Retained by Hospitals and Other
Providers From the 340B Program Grew 12x Since 2013
Source: Berkeley Research Group.
Prescription Medicines: Costs in Context www.phrma.org/cost
12x
16. 16
More Medicines are Available to U.S. Patients as Compared
with Other Countries that Set Prices Artificially Low
The 5-year survival rate for all cancers is 42% higher for men and 15% higher for
women in the U.S. than in Europe.
Source: PhRMA analysis of IQVIAAnalytics Link and U.S. Food and Drug Administration (FDA), European Medicines Agency (EMA) and Japan's Pharmaceuticals and Medical Devices Agency (PMDA) data. April 2021. Note: New active
substances approved by FDA, EMA and/or PMDA and first launched in any country between January 1, 2011, and December 31, 2020. Many launched medicines are subject to additional government coverage restrictions.
Prescription Medicines: Costs in Context www.phrma.org/cost
86%
64%
60%
52%
48% 47%
38%
United States Germany United Kingdom Japan France Canada Australia
Number of New Medicines Available by Country, 2011-2020
17. 17
PhRMA Created the Medicine Assistance Tool, or MAT,
To Help Patients Navigate Medicine Affordability
MAT makes it easier for those struggling to afford their medicines to find and learn
more about various programs that can make prescription medicines more affordable.
Prescription Medicines: Costs in Context www.phrma.org/cost
A search engine to connect patients with
900+
assistance programs offered by
biopharmaceutical companies, including
some free or nearly free options
Resources to help patients
navigate their insurance coverage
Links to biopharmaceutical
company websites where
information about the cost of a
prescription medicine is available
The Medicine Assistance Tool Includes:
18. 18
Making sure patients share in the savings our industry provides
Common-sense, Patient-centered Reforms to Make
Medicines More Affordable
Capping what seniors pay out of pocket for medicines
Addressing insurance practices that restrict access to care
Strengthening safety-net programs to ensure they deliver the support
vulnerable patients need
Learn more at phrma.org/betterway
Prescription Medicines: Costs in Context www.phrma.org/cost